Haematemesis: Treatment, symptoms, advice and help
Haematemesis is defined as vomiting of the blood which can be either fresh or altered. This results from bleeding anywhere in the upper gastrointestinal tract, which includes the oesophagus, the stomach and the duodenum. Haematemesis is a symptom rather than a disease. Several underlying causes may be responsible for haematemesis.
Haematemesis: Incidence, age and sex
Haematemesis is an uncommon occurrence which can afflict an individual of any age group. Both men and women are equally susceptible. Alcoholics and chronic smokers are especially prone to disorders which may subsequently lead to haematemesis.
Signs and symptoms of haematemesis: Diagnosis
Haematemesis is itself a symptom and characterized by vomiting of blood which is mostly the colour of coffee grounds. However, the vomited blood may also be bright red if it is fresh. Very rarely, the vomiting can be sudden and forceful enough to cause a tear in the food pipe. Sometimes, extensive loss of blood may lead to a significant drop in the blood pressure along with rapid pulse rate. This is a medical emergency and must be immediately handled by medical personnel.
A detailed history and comprehensive physical examination, may point towards the diagnosis. An endoscopic examination of the upper gastrointestinal tract may reveal an underlying localised pathology, if any. Similarly, a standard blood test may help in diagnosing any bleeding or clotting disorder.
Causes and prevention of haematemesis
Several causes may lead to haematemesis, of which gastric and duodenal ulcers are most widely known. Longstanding gastric ulcers have a high-risk of bleeding, if they grow into a blood vessel. Chronic gastritis, which results from constant use of NSAID medications, can also lead to haematemesis. Similarly, inflammation of the inner lining of the food pipe may also cause bleeding. Infrequently a small rip in the lower end of the food pipe can also induce bleeding. Cirrhosis of the liver, in later stage, may lead to swelling of the veins of the oesophagus. This may lead to haematemesis in some individuals. Stomach cancer is a rare cause of haematemesis. Furthermore, generalised cause like clotting disorder of blood may also result in bleeding from several sites, and upper gastrointestinal tract is one of them.
Certain factors like smoking, alcohol consumption, medications like NSAIDs, increased intake of caffeine and emotional stress may lead to certain localised gastrointestinal problems which result in haematemesis.
The most common complication of haematemesis is anaemia. Sometimes, sudden and extensive blood loss in an individual, may lead to hypovolemic shock which requires immediate fluid and blood infusion. In seldom instances, even a moderate amount of haematemesis may be potentially life-threatening in old-aged individuals.
The first step in management of haematemesis is a complete evaluation of the condition and its underlying cause. Meanwhile, symptomatic relief may be provided by compensating fluid and blood loss. Subsequent elimination of cause of haematemesis is of essential value to prevent further such episodes. Medications which reduce the production of gastric acids are prescribed to manage gastric and duodenal ulcers. Such medications include ranitidine, omeprazole and lansoprazole. Avoid excessive use of anti-inflammatory drugs like NSAIDs to prevent gastritis. Rarely, surgical intervention may be required if the oesophageal varices are offending factors in leading to haematemesis.